NSAIDs increase risk of gastrointestinal bleeding in primary care patients with dyspepsia.

Background: A 1-year prospective study of 545 patients with dyspepsia examined the natural history of dyspepsia in a primary care population. Predictors of gastrointestinal bleeding and other related utilization-of-service indicators were identified.

Methods: Subjects were adult primary care patients seen at a southern California county medical center.

The rheumatoid factor reactivity of a human IgG monoclonal autoantibody is encoded by a variant V kappa II L chain gene.

To determine the genetic and molecular basis for rheumatoid factor (RF) autoantibody reactivity in patients with destructive, erosive arthritis, we established a human lymphoblastoid cell line (hRF-1) from a patient with polyarthritis that produced an IgG RF mAb, mAb hRF-1. Studies of isolated H and L chains showed that the specificity of RF reactivity is conferred by mAb hRF-1 L chains. The L chain gene was cloned from a cDNA library prepared from hRF-1 cells.

Rheumatoid factors specific for active rheumatoid arthritis.

To measure rheumatoid factors specific for patients with rheumatoid arthritis an enzyme linked immunosorbent assay (ELISA) was developed to measure rheumatoid factors in human serum that bind a cross-reactive determinant shared on human and other mammalian IgG. Rheumatoid factors that cross link human IgG and sheep IgG in a double binding ELISA were almost completely specific (greater than 99%) for rheumatoid arthritis in assays of 108 sera from patients with rheumatoid arthritis compared with 231 sera from patients with other connective tissue diseases and 365 sera from healthy subjects and patients without these diseases. Moreover, positive tests occurred primarily in patients with active arthritis (r = 0.

A conserved anti-DNA antibody idiotype associated with nephritis in murine and human systemic lupus erythematosus.

In order to identify unique structural features of pathogenic autoantibodies to DNA in SLE, a murine anti-anti-DNA (anti-Id) mAb (mAb 1C7) was produced in response to immunization of lupus mice with a syngeneic anti-DNA mAb (mAb 3E10). Immunization of lupus mice with mAb 3E10 inhibited production of native anti-DNA antibodies, suppressed development of lupus kidney disease (nephritis), and induced production of anti-anti-DNA (anti-Id) antibodies. mAb 1C7 bound F(ab')2 fragments of mAb 3E10, and it bound other murine anti-DNA mAb, but not murine mAb or polyclonal serum antibodies unreactive with DNA.

Penicillin anaphylaxis: fatality in elderly patients without a history of penicillin allergy.

Two anaphylactic fatalities following penicillin administration are reported. Neither of the two patients had a history of previous penicillin allergy. Both were elderly and suffered from active cardiovascular disease.